MEDICARE: IQRA IQBAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	2022003373	MO
2	207R00000X	Internal Medicine Physician	2022003373	MO

General Provider Information

NPI Number	:	1104353614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IQRA IQBAL M.D.

Provider Business Mailing Address
First Line	:	615 S NEW BALLAS RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8221
Country	:	US
Telephone Number	:	314-251-6339
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 S GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-1016
Country	:	US
Telephone Number	:	314-257-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2017
Last Update Date	:	12/07/2025

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